info:eu-repo/semantics/article
Evaluation of cytokines in endocervical secretions of women with candidiasis, trichomoniasis or bacterial vaginitis.
Avaliação de citocinas em secreção endocervical de mulheres com candidíase, tricomoníase ou vaginite bacteriana
Author
Campos, Ana Claudia Camargo
Murta, Eddie Fernando Candido
Michelin, Márcia Antoniazi
Paulinelli, Régis Resende
Reis, Cleomenes
Institutions
Abstract
Infectious processes in the vagina due to infectious micro-organisms are very common. Vulvovaginitis is commonly caused by protozoa, yeasts, bacteria and/orviruses and their eradication or containment are usually mediated by cytokines ofthe vaginal mucosa. In this study, the intention was to measure the concentration of cytokines IL-2, IL-6, IL-10, IL-12, IFN-? and TNF-? and their relationship with some of the infections. One-hundred and seventy three women were included, with ages between 16 and 48 years (mean=31.4 ± 6.5 years). They were distributed into four groups: control, candidiasis, trichomoniasis and bacterial vaginitis group. The samples were subsequently submitted to culture and identification of micro-organism, followed by cytokine measurements. The data was submitted to statistical analysis. Median, interquartile range and the Mann-Whitney test was employed and considered significant when p<0.05. The levels of cytokines in the lower genital-tract of women with candidiasis, trichomoniasis, bacterial vaginitis were higher than those with normal flora. Sixty (34.7%) women were in the control group, 19 (11.0%) presented only candidiasis, three (1.7%) presented trichomoniasis, and only ten presented (5.8%) bacterial vaginosis. The remaining participants had comorbidities such as HPV or bacterial vaginosis, although the study of these last two or association with other conditions was not performed. IL-2 and IL-12 were significantly elevated in the presence of candidiasis, compared with the control group p=0.01 and p=0.07, respectively. Patients with bacterial vaginitis also had statistically significant increased levels for IL-2 (p=0.03) and for IL-12 (p=0.04). TNF-? was elevated only in the presence of trichomoniasis p=0.04. We concluded that patients with vaginal infections had an increase in the concentrations of some cytokines. Os processos infecciosos na vagina devidos a micro-organismos sao muito comuns. As vulvovaginites sao, em grande parte, causadas por protozoarios, leveduras, bacterias e/ou virus. Sua erradicacao ou contencao e normalmente mediada pelas citocinas da mucosa vaginal. O presente estudo teve a intencao de verificar a concentracao de citocinas IL-2, IL-6, IL-10, IL-12, IFN-ƒÁ, TNF-ƒ e suas relacoes com alguns dos agentes das infeccoes. Foram incluidas 173 mulheres sexualmente ativas com idade entre 16 e 48 anos, media de 31,4 } 6,5 anos, as quais foram divididas nos seguintes grupos: controle, com candidiase, com tricomoniase e com vaginite bacteriana. As amostras foram submetidas ao cultivo e, posteriormente, a identificacao do micro-organismo. Em seguida, foi feita a dosagem de citocinas da secrecao endocervical por meio do teste ELISA. Os dados foram submetidos a analise estatistica, calculando-se a mediana e o intervalo interquartil, e ao teste Mann-Whitney. Os resultados foram considerados significantes com p < 0,05. Verificou-se uma maior concentração de diferentes citocinas no trato genital inferior de mulheres com candidiase, tricomoniase, vaginite bacteriana do que naquelas com microbiota normal. No grupo controle, foram incluidas 60 (34,7%) mulheres; nos outros grupos, 19 (11,0%) apresentavam somente candidiase; 3 (1,7%), somente tricomoniase e 10 (5,8%), vaginite bacteriana; as demais apresentaram outras intercorrencias como HPV ou vaginose bacteriana, entretanto nao foi realizado o estudo destes casos ou da sua associação com os demais grupos. IL-2 e IL-12 mostraram-se significativamente elevadas na presenca de candidiase, quando comparadas ao grupo controle, com p = 0,01 e p = 0,07, respectivamente. As pacientes com vaginite bacteriana tambem apresentaram niveis expressivamente aumentados com p=0,03 para IL-2 e p=0,04 para IL-12. O TNF-ƒ¿ mostrou-se elevado na presença de tricomoniase, com p = 0,04. Os resultados encontrados permitem sugerir que pacientes com diferentes infecções vaginais apresentam alterações na concentração de algumas citocinas.